Immune checkpoint blockade in CNS tumors

Published on February 29, 2016   48 min

Other Talks in the Series: Immunotherapy of Cancer

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Hello, my name is David Reardon and I'm the Clinical Director of the Center for Neuro-Oncology at the Dana-Farber Cancer Institute in Boston, Massachusetts in the United States. Thank you for joining us for this Henry Stewart Talk on immune checkpoint blockade in central nervous system tumors.
On the first slide, I've summarized the outcome for patients with glioblastoma in 2016. On the upper part of the slide, we see the standard of care therapy for newly diagnosed glioblastoma patients that include maximum safe surgical resection, followed by radiation with daily temozolomide, after which patients receive five-day temozolomide adjuvant cycles every 28 days for 6-12 cycles. We see on the right that the outcome with this standard of care, which was established over 10 years ago, leaves a lot of room for improvement. The median progression-free survival is only about eight months for patients, which means they're about two-thirds of the way through their plan treatment and the average patient is already progressing. Unfortunately, median survival is only about 15-18 months. Inevitably, patients recur, and the historical outcome for patients with recurrent glioblastoma is summarized in the lower half of this slide, where we see data from a series of meta-analyses of clinical trials conducted through various cooperative groups in North America and in Europe. What we see is that the outcome with the salvage therapies utilized in these clinical trials, which include various chemotherapeutic regimens, biologically-based targeted therapies, and a variety of other innovative strategies, unfortunately, have yielded very poor outcome with six-month progression-free survival rates typically, approximately 10 percent. With the use of bevacizumab, the prototypic VEGF blocking anti-angiogenic agent, we can improve progression-free survival with a six month PFS rate of up to 40 percent. But, this still leaves much room for improvement, and unfortunately, bevacizumab does not improve overall survival.